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Niebler JAP, Patel NTP, Ganapathy AS, Sanin GD, Cambronero GE, Jordan JE, Lane MR, Williams TK, Neff LP. Dynamic Aortic Pressure Augmentation as a Novel Method of Swine Terminal Blood Extraction. J Surg Res 2024; 294:183-190. [PMID: 37913725 DOI: 10.1016/j.jss.2023.09.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 11/03/2023]
Abstract
INTRODUCTION Uncontrolled hemorrhage models require sufficient quantities of donor blood products to support resuscitation. To that end, we describe a novel method of whole blood extraction from donor swine using resuscitative endovascular balloon occlusion of the aorta (REBOA) to support hemodynamics during terminal blood extraction and its impact on the quality of banked blood. METHODS Ten adult Yorkshire-cross swine were anesthetized and instrumented with an REBOA catheter, femoral multistage venous cannula, and proximal/distal blood pressure monitoring. Hemodynamics during terminal blood extraction was supported with hand-titrated partial REBOA. Blood samples were taken at set time points for analysis. RESULTS The median collected blood volume was 3912 mL, with all animals surviving through the planned blood collection of 60% estimated total blood volume (ETBV). Median lactate and potassium levels remained within normal limits for swine through collection of 40% of the ETBV. Median hemoglobin through collection of 40% ETBV did not significantly change from values measured at the start of hemorrhage. CONCLUSIONS This method of whole blood extraction provided sufficient blood volume and blood quality appropriate for transfusion through 40% ETBV, with remaining collected blood likely still acceptable for allogeneic transfusion despite increased lactate levels. This method of whole blood extraction can efficiently provide a large volume of quality blood to support resuscitation for subsequent uncontrolled hemorrhage models.
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Affiliation(s)
| | - Nathan T P Patel
- Department of General Surgery, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina
| | - Aravindh S Ganapathy
- Department of General Surgery, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina
| | - Gloria D Sanin
- Department of General Surgery, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina
| | - Gabriel E Cambronero
- Department of General Surgery, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina
| | - James E Jordan
- Department of Cardiothoracic Surgery, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina
| | - Magan R Lane
- Department of Vascular/Endovascular Surgery, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina
| | - Timothy K Williams
- Department of Vascular/Endovascular Surgery, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina
| | - Lucas P Neff
- Department of General Surgery, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina
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Cognasse F, Hally K, Fauteux-Daniel S, Eyraud MA, Arthaud CA, Fagan J, Mismetti P, Hamzeh-Cognasse H, Laradi S, Garraud O, Larsen P. Effects and Side Effects of Platelet Transfusion. Hamostaseologie 2021; 41:128-135. [PMID: 33711849 DOI: 10.1055/a-1347-6551] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Aside from their canonical role in hemostasis, it is increasingly recognized that platelets have inflammatory functions and can regulate both adaptive and innate immune responses. The main topic this review aims to cover is the proinflammatory effects and side effects of platelet transfusion. Platelets prepared for transfusion are subject to stress injury upon collection, preparation, and storage. With these types of stress, they undergo morphologic, metabolic, and functional modulations which are likely to induce platelet activation and the release of biological response modifiers (BRMs). As a consequence, platelet concentrates (PCs) accumulate BRMs during processing and storage, and these BRMs are ultimately transfused alongside platelets. It has been shown that BRMs present in PCs can induce immune responses and posttransfusion reactions in the transfusion recipient. Several recent reports within the transfusion literature have investigated the concept of platelets as immune cells. Nevertheless, current and future investigations will face the challenge of encompassing the immunological role of platelets in the scope of transfusion.
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Affiliation(s)
- Fabrice Cognasse
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France.,SAINBIOSE, INSERM U1059, University of Lyon, Université Jean-Monnet-Saint-Etienne, France, France
| | - Kathryn Hally
- Department of Surgery and Anaesthesia, University of Otago, Wellington, New Zealand.,Wellington Cardiovascular Research Group, Wellington, New Zealand.,School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand
| | - Sebastien Fauteux-Daniel
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France.,SAINBIOSE, INSERM U1059, University of Lyon, Université Jean-Monnet-Saint-Etienne, France, France
| | - Marie-Ange Eyraud
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France.,SAINBIOSE, INSERM U1059, University of Lyon, Université Jean-Monnet-Saint-Etienne, France, France
| | - Charles-Antoine Arthaud
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France.,SAINBIOSE, INSERM U1059, University of Lyon, Université Jean-Monnet-Saint-Etienne, France, France
| | - Jocelyne Fagan
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France.,SAINBIOSE, INSERM U1059, University of Lyon, Université Jean-Monnet-Saint-Etienne, France, France
| | - Patrick Mismetti
- SAINBIOSE, INSERM U1059, University of Lyon, Université Jean-Monnet-Saint-Etienne, France, France
| | - Hind Hamzeh-Cognasse
- SAINBIOSE, INSERM U1059, University of Lyon, Université Jean-Monnet-Saint-Etienne, France, France
| | - Sandrine Laradi
- Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France.,SAINBIOSE, INSERM U1059, University of Lyon, Université Jean-Monnet-Saint-Etienne, France, France
| | - Olivier Garraud
- SAINBIOSE, INSERM U1059, University of Lyon, Université Jean-Monnet-Saint-Etienne, France, France
| | - Peter Larsen
- Department of Surgery and Anaesthesia, University of Otago, Wellington, New Zealand.,Wellington Cardiovascular Research Group, Wellington, New Zealand.,School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand
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Nozaki I, Aung T, Oo NN, Kodoi H, Ito Y, Inaba T, Shiratori K. Enhancing the blood safety program in Myanmar: Report on projects of global extension of medical technologies of Japan. Glob Health Med 2021; 3:48-51. [PMID: 33688596 DOI: 10.35772/ghm.2020.01071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/26/2020] [Accepted: 10/06/2020] [Indexed: 11/08/2022]
Abstract
The National Center for Global Health and Medicine has long collaborated with the blood program in Myanmar, and the Center started a new project in 2015 to enhance blood transfusion safety as part of a new set of projects of global extension of medical technologies that aims to improve public health and medicine in developing countries under public-private partnerships. The project resulted in remarkable achievements, including maintaining a high proportion of voluntary blood donations despite a rapidly growing demand for blood, ensuring blood safety from the donor to the recipient, and creating public-private partnerships. The project supported the introduction of blood grouping using the tube method at hospital blood banks, safety measures during blood transfusions, and effective use of blood products including component blood. The project identified the need for medical devices such as leukocyte filters, serofuges, and refrigerators to store blood products. The success of the project may depend on mutual understanding and trust based on the duration of collaboration, improvement of the requirement for medical safety (including blood safety) in the country, and shifting the mindset of partner companies in public-private partnerships to create new demand by encouraging improvement of the quality of care and requiring the safety of medical care. In this era of sustainable development goals, the hopes are that these experiences will help other countries seeking to improve their public health through public-private partnerships.
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Affiliation(s)
- Ikuma Nozaki
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Thida Aung
- National Blood Center, Department of Medical Services, Ministry of Health and Sports, Yangon, Myanmar
| | - Nwe Nwe Oo
- National Blood Center, Department of Medical Services, Ministry of Health and Sports, Yangon, Myanmar
| | - Haruka Kodoi
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yui Ito
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takashi Inaba
- Clinical laboratory, National Center for Global Health and Medicine, Tokyo, Japan
| | - Katsuyuki Shiratori
- Clinical laboratory, National Center for Global Health and Medicine, Tokyo, Japan
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